Bootcongres

Introduction. The number of organ donors is limited by the many contraindications for donation and often poor quality of potential organ donors. Moreover, the demand of organs greatly exceeds the supply of donor organs. The risk of donor-to-recipient disease transmission withholds physicians to accept an organ for transplantation. Abdominal infection is one of these generally accepted contraindications for kidney donation. We report the first successful kidney transplantation of a donor with intestinal perforation and massive abdominal contamination with bowel contents. Case report. We present a 43-year-old male donor with lethal brain injury and blunt abdominal trauma. Initial assessment with abdominal CT-scan showed free intraperitoneal air and fluid suggesting intestinal perforation. After withdrawal of life sustaining treatment and circulatory arrest, a minilaparotomy confirmed abdominal contamination with intestinal content. After closure of the abdomen, organs were preserved with in situ preservation with an aortic cannula inserted via the femoral artery. Thereafter, the kidneys were procured via bilateral lumbotomy. Results. Both kidneys were successfully transplanted, without post-operative infection in both recipients. Six months after transplantation the kidneys functioned well. 

Conclusions. We conclude that intestinal perforation is not an absolute contraindication for kidney donation. Kidneys can be preserved with in situ preservation and procured with a retroperitoneal approach.